Sotalol v flecanide

[kalgs]

I feel lost with my current position.

I suffer with PAF and ectopics. My cardiologist and nurse recommended flecanide and arranged a blood test to see if my heart was ok . I asked about echo and ecg . In wales they don’t do that they said . So I’m all prepared to start flecanide.

Out of the blue a letter says go to your GP we suggest you go on Sotalol. No discussion or reason given. Blood test is fine .

I asked why the change and basically they said it’s my choice .

It’s my understanding that Sotalol is not recommended for PAF and has some really nasty side effects ?

[manabouttown]

I have Paroxysmal AF , and I'm on Flecainide (2 tabs of 50mg a day) ,plus one tab of rivaroxaban (xarelto).

[CDreamer]

Any antiarrythmic has the potential to cause other more serious than AF arrythmias which is why monitoring ie: ECG’s, Echocardiogram and regular blood draws, are required for anyone on these drugs.

Personally I refused Sotolol and accepted Flecainide which helped for a couple of years before going to ablation. If I had my time again I’d skip all the drugs except for anticoagulants and go straight to ablation and Lifestyle changes but hindsight is a gift I wasn’t blessed with.

I have come to believe that most doctors seem to favour one drug or another because of their personal experience with their patients. As patients we tend to all react very differently to different substances, some people on this forum say Sotolol works for them whilst I was warned off Sotolol by an EP who was instrumental in getting the NICE guidelines changed so it wasn’t advised for people with Lone AF - if there is such a thing?

That was good enough advice for me.

[kalgs in reply to CDreamer]

Forgive my ignorance what’s lone AF ?

[CDreamer in reply to kalgs]

When AF appears with significant co-morbidities such as Thyroid, Hypertension, Obesity, Diabetes etc.

[kalgs in reply to CDreamer]

Thanks

[Finvola]

My understanding is that Sotalol is not usually prescribed for AF in the UK because the strength of dose required to control it is considered to be too high. Having said that, there are people on the forum who take it without problems. I was prescribed it but had to stop after only 4 days as it didn't agree with me at all.

Normally before Flecainide is prescribed an echo and ECG would be done to ensure that your heart is structurally sound - certainly here in N Ireland it is standard practice. Can a blood test determine enough? I have taken Flecainide for 7 years and have an ECG every 6 months - latest one was this morning.

I don't know the setup in Wales but it seems strange to suddenly decide on Sotalol without giving you any info - and then saying it is your choice? How can it be when you don't have the facts? Perhaps you need to have a talk with your GP and try to find out what is going on, why and what tests would normally be done before Flecainide is prescribed. Best wishes with it and I hope someone from Wales can answer more fully than I have done.

[kalgs in reply to Finvola]

Thanks

[CDreamer in reply to kalgs]

Your GP may see Sotolol as a cheaper option but whatever you do, insist on regular monitoring. ECG and BP you can do for yourself with modern technology but you do need baseline blood results for FBC, Liver & Kidney functions prior to starting drugs and then periodic monitoring every 6-12 months thereafter.

[kalgs in reply to CDreamer]

Thanks

[Jetcat]

I think cdreamer meant to say lone afib is classed lone when there is no other co morbidities.

[kalgs in reply to Jetcat]

Thanks

[CDreamer in reply to Jetcat]

Absolutely correct I left out the word NO.

[Jetcat in reply to CDreamer]

Easily done mate, I do it a lot especially with this predictive text thing.👍

[Elli86]

Hi kalgs. I have been reccomended sotalol also. Would like to here thoughts on it. I did another post as well asking about this, bisop and nebivolol but doesn’t seem many people take sotalol. I’m in a position similar to you where I’m still trying to make my mind up.

Flec was terrible for me so that won’t be an option

[kalgs in reply to Elli86]

I’ve just had a conversation with the special cardiac nurse. Left the decision to me .

[Elli86 in reply to kalgs]

That’s helpful 🤣 if it were me I’d be sotalol all day long but that’s because flec didn’t agree with me and everyone’s different

[kalgs in reply to Elli86]

Thanks

[Dollcollector]

I do not understand why you were told that they don't do e. c.g s and echo 's in Wales. I live in Wales and l have lost count of the number of e.c.g s l have had. I have also had 3 echocardiograms. I have aloop recorder implanted at the moment and am considering whether to have a pacemaker put in. I would have thought that having a scan on your heart would help in deciding which medication to take, also depending how bad and how often your p.a.f. is. Finding the right medication that helps you and doesn't make you feel ill is the most difficult part.

[kalgs in reply to Dollcollector]

It’s the particular hospital on South Wales . Won’t do an echo unless bloods indicate an issue . Had an echo and ecg 2 years ago

[Dollcollector in reply to kalgs]

That is a long time. You can deteriate a lot in that time. I'm sorry you are not getting the care you are entitled to x

[kalgs in reply to Dollcollector]

Thanks

[Ecki]

I've been on sotalol for about 2 years, only issue is that it triggered my asthma. EP reduced the dose and I'm fine now, no other side effects.

[kalgs in reply to Ecki]

Thanks

[Sixtychick]

I’ve been on Sotalol 40mgs twice a day, for many years. I don’t have any problems with it. It was given it for SVT and it helped better than the Atenolol I was on. I have now had 3 episodes on AFib since 2014, but they kept me on the Sotalol. Only thing is there are a lot of drugs that react with it. I have the NICE list of drug reactions with Sotalol, on my phone,so if I am prescribed anything or want an over the counter medication. i can check it is safe to take first.

[kalgs in reply to Sixtychick]

Many thanks